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Kasaragod, Jul 26: First funeral, now wedding. Forty-three persons who attended a wedding at Pilankatta in Chengala panchayat in Kasaragod on July 17 have tested positive for Covid-19, said district medical officer (DMO) A V Ramdas.

They include the bride and the groom. Collector D Sajith Babu has asked all those who attended the wedding to go into home quarantine for 14 days. Those with Covid symptoms should get in touch with the nearest primary health centre, he said.

The DMO said samples of 128 persons linked to the wedding were tested, of which 43 turned out positive. Earlier, 44 persons who attended a funeral in Cherkala in the first week of July had tested positive. The funeral was declared a cluster and the government had to test 522 persons linked to the funeral.

The collector said those taking part in funeral or weddings without following the Covid protocol would be booked under the Kerala Epidemic Diseases Act. If convicted, they would face up to two years of rigorous imprisonment and a fine of `10,000. Kasaragod police said they will register a case in connection with the wedding. 

Pilankatta ward member Abdulla Kunhi K B said it was not a big fat wedding. The ceremony held at the bride’s house at Pilankatta was attended by less than 100 people, he said.“Theirs is a big family with four houses in one compound. 

As many as 30 members are staying in these houses,” said Kunhi. Nine of the 30 have tested positive.Of the 15 guests, who came from the bride’s mother’s house, 12 contracted the infection. “The rest of the infected persons were among the groom’s guests,” said Kunhi, who did not attend the wedding. The groom and the bride’s father returned from Dubai three months ago.

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May 12: Children suffering from non-respiratory disease symptoms like diarrhea and fever, or those with a history of exposure to the novel coronavirus, should be suspected of having COVID-19, a new study says.

According to the research, published in the journal Frontiers in Pediatrics, gastrointestinal symptoms first suffered by some children hints at potential infection with SARS-CoV-2 through the digestive tract.

"This case series is the first report to describe the clinical features of COVID-19 with non-respiratory symptoms as the first manifestation in children," the scientists from Tongji Hospital in China wrote in the study.

They explained that the gastrointestinal symptoms could be arising since the type of receptors in lung cells targeted by the virus can also be found in the intestines.

Most children are only mildly affected by COVID-19, and the few severe cases often have underlying health issues, the researchers said.

"It is easy to miss its diagnosis in the early stage, when a child has non-respiratory symptoms, or suffers from another illness," said study co-author Wenbin Li, who works at the Department of Pediatrics, Tongji Hospital.

"Based on our experience of dealing with COVID-19, in regions where this virus is epidemic, children suffering from digestive tract symptoms, especially with fever and/or a history of exposure to this disease, should be suspected of being infected with this virus," Li said.

In the study, the scientists described the clinical features of children admitted to hospital with non-respiratory symptoms, who were subsequently diagnosed with pneumonia and COVID-19.

"These children were seeking medical advice in the emergency department for unrelated problems, for example, one had a kidney stone, another a head trauma," Li said.

The study noted that all the children had pneumonia, which was confirmed by chest X-ray scan before or soon after admission.

These children were then confirmed to have COVID-19.

While their COVID-19 symptoms were initially mild or relatively hidden before their hospital admission, four out of the five cases had digestive tract symptoms as the first manifestation of this disease, the researchers said.

Li hopes that doctors will use the findings to quickly diagnose and isolate patients with similar symptoms, which may aid early treatment and reduce transmission.

According to the researchers, the children's gastrointestinal symptoms, which have also been recorded in adult patients, could be an additional route of infection.

"The gastrointestinal symptoms experienced by these children may be related to the distribution of receptors and the transmission pathway associated with COVID-19 infection in humans," Li explained.

Since the virus infects people via the ACE2 receptor, which can be found in certain cells in the lungs as well as the intestines, COVID-19 might infect patients not only through the respiratory tract in the form of air droplets, but also through the digestive tract by contact or fecal-oral transmission, the study noted.

While COVID-19 tests can occasionally produce false positive readings, Li said all the five children assessed in the study were infected with the disease.

However, he cautioned that more research is needed to confirm their findings.

"We report five cases of COVID-19 in children showing non-respiratory symptoms as the first manifestation after admission to hospital. The incidence and clinical features of similar cases needs further study in more patients," he said.